title: Colon transit time and anorectal manometry in children and young adults with spina bifida.
abstract: OBJECTIVE
  This study evaluates colon transit time (CTT) and anorectal manometry (ARM) in spina bifida (SB) patients in relation to the level of lesion, mobility, constipation, and continence status.
  
  
  METHODS
  SB patients between 6 and 19 years, who are not using antegrade continence enemas and followed at the SB Reference Centre UZ Ghent, were asked to participate. Medical history was retrospectively retrieved from the medical file. Stool habits were prospectively collected using standardized questionnaires. CTT was measured using the 6-day pellet abdominal X-ray method. ARM was performed in non-sedated children with a water-perfused, latex-free catheter.
  
  
  RESULTS
  Forty out of 52 eligible patients consented to perform CTT, of which 19 also performed the ARM. Fifteen (37 %) SB patients were constipated despite treatment. Twenty-six (65 %) were (pseudo) continent. The total CTT was significantly prolonged in SB patients (median CTT 86.4 vs. 36 h controls). The CTT was significantly prolonged in constipated SB patients compared to non-constipated SB patients (122.4 vs. 52.8 h). Spontaneously continent patients had a normal CTT (33.6 h) as well as a significantly higher resting pressure compared to the pseudo-continent and incontinent SB patients (resting pressure 56.5 vs. 32.5 mmHg). An abnormal CTT was associated with a treatment necessity to achieve pseudo-continence (p = 0.006).
  
  
  CONCLUSIONS
  CTT in SB patients was significantly prolonged, indicating a neurogenic involvement of the bowel and slow transit constipation. SB patients with a normal CTT and a normal ARM spontaneously achieved fecal continence. CTT can help tailor the continence therapy in SB patients.
authors.affiliation: Department of Pediatric Gastroenterology, University Hospital Ghent, De Pintelaan 185, 3K12D, 9000, Ghent, Belgium, saskia.vandevelde@ugent.be.
authors.forename: S Vande
authors.initials: SV
authors.lastname: Velde
authors.forename: L
authors.initials: L
authors.lastname: Pratte
authors.forename: H
authors.initials: H
authors.lastname: Verhelst
authors.forename: V
authors.initials: V
authors.lastname: Meersschaut
authors.forename: N
authors.initials: N
authors.lastname: Herregods
authors.forename: M
authors.initials: M
authors.lastname: Van Winckel
authors.forename: S
authors.initials: S
authors.lastname: Van Biervliet
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000503:physiopathology*; D002648:Child; D003106:Colon / Q000503:physiopathology*; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D008297:Male; D008365:Manometry; D012007:Rectum / Q000503:physiopathology*; D016135:Spinal Dysraphism / Q000503:physiopathology*; D013997:Time Factors; D055815:Young Adult